Organization Active NPI

Medford Medical

  • Family Medicine Physician
  • Glen Head, NY
National Provider Identifier
1669328423
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDFORD MEDICAL
Practice address
699A Glen Cove Ave
Glen Head, NY 11545
Phone
(516) 858-1828
NPI assigned
Mar 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ricky Vohora, DONPI 1669756599
Title
Ceo
Phone
(516) 858-1828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

699A Glen Cove Ave
Glen Head, NY 11545

Mailing address

2608 Route 112
Medford, NY 11763-2551
Phone (631) 475-4476

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2342961Medford Medical Inc699 Glen Cove Ave, Glen Head, NY 11545Certificate of waiverApr 28, 2028

National Provider Directory

National Provider Directory

Locations

699 Glen Cove Ave
#A
Glen Head, NY 11545
Phone (516) 858-1828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1772668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1669328423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 ROUTE 112",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632551",
            "telephone_number": "631-475-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699A GLEN COVE AVE",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-858-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "VOHORA",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-858-1828",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.